Prof. Dr. Emel Akoğlu
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- 57+years exp.
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Andrology & Men's Health
Peyronie's disease surgery
What Peyronie's disease surgery is, when curvature is stable enough to operate, how plication, plaque incision with grafting and a penile prosthesis differ, what the evidence says about straightening and length loss, approximate costs in Turkey against the UK, US and Germany, recovery, risks and questions to ask a urologist.
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Prof. Dr. Zerrin Biçik Bahçebaşı
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Peyronie's disease surgery in Turkey: what it is and when it is used
Peyronie's disease surgery is an operation to straighten a penis bent by a scar plaque in the tunica albuginea, the fibrous sheath around the erectile tissue. The disease causes a curve, sometimes an indentation or hourglass narrowing, a palpable lump, shortening and often pain in the early months. Many men also develop erectile difficulty. Surgery is usually offered when the disease has been stable for at least three to six months, the curve or deformity prevents or hurts intercourse, and non-surgical treatment has not helped. Urologists in Turkey perform the main operations, and patients travel for them from Europe because waiting times for functional urology can be long.
This guide explains how the stable and active phases differ, the three kinds of operation, what each can and cannot do, approximate costs in Turkey compared with the UK, US and Germany, and how recovery works. It is general information; a urologist must examine you. For the wider specialty see our urology treatments in Turkey.
Is my Peyronie's disease stable enough for surgery?
Peyronie's disease has two phases. In the acute (active) phase, usually the first 6 to 18 months, the plaque is forming, the curve may still change and there is often pain with erections. Surgery is generally avoided then, because the deformity can progress after the operation. In the chronic (stable) phase the pain has settled and the curvature has not changed for at least three months, and often longer. Urologists use the history, photographs of the erection taken at home, and sometimes an injection-induced erection with ultrasound to measure the angle and confirm stability. Guidelines from the American Urological Association and the European Association of Urology both advise operating only on stable disease, so a clinic that offers to operate straight away should be asked to explain why.
What are the types of Peyronie's disease surgery?
There are three main operations, chosen mostly by the severity of the curve, the length of the penis and the quality of your erections.
- Plication (tunica shortening, e.g. Nesbit or 16-dot). Sutures or small excisions on the long side of the penis shorten it to match the short side. It is the simplest operation and is used for curves under about 60 degrees.
- Plaque incision or excision with a graft. The scar is cut and the gap covered with a patch of tissue or a synthetic or collagen graft, so the short side lengthens. It is used for larger or complex curves in men with good erections.
- Penile prosthesis, with or without straightening. An inflatable or malleable implant is placed when erections are poor; any remaining curve is then straightened by manual modelling or a small incision.
Plication, grafting or implant: how do they compare?
| Operation | Best suited to | Typical limits |
|---|---|---|
| Plication | Curve under about 60°, good erections, no severe hourglass | Some loss of length; may leave a small residual curve |
| Incision or excision with graft | Larger or complex curve with good erections | Risk of worse erections and numbness; longer operation |
| Penile prosthesis | Peyronie's with erectile dysfunction that medicine does not help | Device surgery with its own risks; see penile prosthesis |
The choice should be made on a clear description of your curve, length and erections. Cosmetic options such as penis enlargement or fillers do not treat Peyronie's disease and can worsen scarring.
Does Peyronie's disease surgery work?
For stable disease, surgery is the only treatment that reliably straightens a significant curve. Studies of plication report that most men achieve a functional straightening, while grafting also straightens most men but carries a higher chance of erectile function becoming worse. The honest points to know are that no operation restores the penis to its pre-disease state, that some shortening is common (more with plication, though grafting avoids shortening in many men), and that a straight penis does not mean the erection is better than before. Patient satisfaction is generally high when expectations were realistic and when the operation matched the disease. If your main problem is erectile dysfunction, an implant addresses both issues.
How much does Peyronie's disease surgery cost in Turkey?
The ranges below are approximate and do not come from any hospital; each hospital confirms its own price.
| Country | Approximate cost range |
|---|---|
| Turkey | €2,500 – €9,000 |
| United Kingdom | €6,000 – €16,000 (private) |
| United States | €9,000 – €30,000 |
| Germany | €5,000 – €14,000 |
What changes the price: plication sits at the lower end and grafting or a penile prosthesis at the upper end (the implant device itself is a large share), the type of graft, the length of stay, and the pre-operative tests. A package should list the consultation, tests such as penile ultrasound, the operation, anaesthesia, one or two hospital nights and follow-up. Ask what is not included, for instance revision surgery.
What happens during the operation, step by step?
The operation is under general or spinal anaesthesia and takes 45 minutes for plication to two or three hours for grafting. In most operations a circumcision-type incision is made around the shaft and the skin is rolled back. The surgeon then performs an artificial erection test, injecting saline into the penis to confirm the curve. For plication the opposite side of the curve is shortened with stitches; for grafting the plaque is incised and covered with a graft, and the skin is closed. The test is repeated to confirm a straight erection. A dressing is placed, and some surgeons use a catheter for a night.
Peyronie's disease surgery recovery: what to expect after surgery
Most men go home within one or two days. Expect swelling, bruising and tenderness for one to two weeks, with a loose dressing and showers after a few days. You can usually return to desk work after one to two weeks. Many surgeons advise gentle stretching or massage of the penis from a few weeks, but only if your surgeon recommends it, and avoiding intercourse and masturbation for about four to six weeks, sometimes longer after grafting. Phosphodiesterase inhibitors may be prescribed to protect erections. Plan to stay in Turkey for four to seven days so the stitches and swelling can be checked.
What are the risks of Peyronie's disease surgery?
Common effects are swelling, bruising and temporary numbness. Possible risks include a feeling of shortening, a residual or recurrent curve, erectile dysfunction, particularly after grafting, loss of sensation in the glans, a palpable knot from stitches, infection, haematoma and, with an implant, device failure or infection needing removal. Disease progression after surgery is possible, which is why stability matters. The NHS and the urology societies advise that surgery is a considered choice after discussion of these risks, and a patient should leave the consultation understanding them.
Who should have surgery, and who should wait?
Surgery suits men with stable Peyronie's disease, a curvature or deformity that stops satisfactory intercourse, and realistic goals. Waiting is wiser if your disease is still active or your curve is mild and not troubling, since mild curves often need no treatment. Men with severe erectile dysfunction may do better with an implant than with straightening alone, and men with significant hourglass narrowing may need grafting. Medical measures such as traction therapy, injections of collagenase or oral medication are options for some men earlier in the disease; a urologist should explain where you fit.
How to choose a urologist and hospital, and questions to ask
Look for a urologist who performs Peyronie's and penile prosthesis surgery regularly, in a licensed hospital, with a written plan and price. Red flags: no examination of your curve before quoting, promises of a perfectly straight penis with no length loss, fillers or injections offered as a cure and pressure to book quickly. Read how our process works and send photographs and history through the free quote page. Questions to ask:
- Is my disease stable and how do you know?
- Which operation do you recommend for my curve, and why not the others?
- How much length might I lose, and what are the chances my erections get worse?
- How many of these operations do you perform each year?
- What are your results and revision rates?
- What aftercare is included, and who will see me at home?
Conditions treated with Peyronie's Disease Surgery
Hospitals with Urology in Turkey
Frequently asked questions
It is an operation to straighten a penis bent by a scar plaque in its sheath. The main types are plication, plaque incision with a graft, and a penile prosthesis for men who also have erectile dysfunction.
Usually once the disease has been stable for three to six months or more, pain has settled and the curve makes intercourse difficult or painful. Surgery during the active phase risks further progression.
For stable disease it is the most reliable way to straighten a significant curve. Some shortening is common and erections do not always return to how they were before, so expectations need to be realistic.
Approximate range is €2,500 to €9,000 against about €6,000 to €16,000 privately in the UK. The price depends on the operation type, with implants at the upper end, and is confirmed in a written quote.
Plication shortens the longer side and can cost some length, while grafting often avoids that. Your surgeon should measure you before and explain the likely change.
Most men go home in one or two days, return to desk work in one to two weeks and avoid sexual activity for about four to six weeks. Your surgeon sets the exact timeline.
You are asleep or numbed during the operation. Afterwards there is soreness, swelling and bruising for one to two weeks, usually controlled with simple painkillers.
They include shortening, a residual curve, worse erections, reduced sensation, infection and, with grafting, a higher risk of erectile change. Ask the surgeon how often these happen in their own patients.
Some men benefit from traction devices, collagenase injections or oral medicine in the early phase, and mild curves often need no treatment. Surgery is for stable, troublesome curvature.
Plan four to seven days so the surgeon can check swelling and stitches before you fly. Implant surgery may need a little longer.
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